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作 者:杨帆[1] 吕坤龙 王瑞[1] Yang Fan;Lyu Kunlong;Wang Rui(Department of Andrology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)
出 处:《中国实用医刊》2024年第15期10-13,共4页Chinese Journal of Practical Medicine
基 金:河南省医学科技攻关计划项目(No.2018020144)。
摘 要:目的研究显微镜下精索内静脉结扎术在精索静脉曲张(VC)中的应用及对患者促性腺激素的影响。方法队列研究。抽取2022年3月至2023年2月郑州大学第一附属医院收治的VC患者86例,按随机数字表法分为显微镜组和腹腔镜组,每组43例。显微镜组采用显微镜下精索内静脉结扎术,腹腔镜组采用腹腔镜精索内静脉结扎术。比较两组围术期指标、精子质量、促性腺激素[卵泡刺激素(FSH)、促黄体生成素(LH)、睾酮(T)]水平、国际勃起功能评分表(IIEF-5)评分及并发症发生率。结果与腹腔镜组相比,显微镜组手术时间长、术中出血量少且住院天数短(P<0.05)。术后6个月,显微镜组活动精子数、精子存活率高于腹腔镜组(P<0.05);术后6个月,显微镜组FSH、LH水平低于腹腔镜组,T水平高于腹腔镜组(P<0.05);术后6个月,显微镜组IIEF-5评分高于腹腔镜组(P<0.05)。显微镜组并发症发生率(4.65%,2/43)低于腹腔镜组(20.93%,9/43),P<0.05。结论显微镜下精索内静脉结扎术治疗VC效果显著,能减少术中出血量,缩短住院天数,提升精子存活率和活动率,改善患者促性腺激素水平,且并发症少,预后较好。Objective To investigate the application of microsurgical internal spermatic vein ligation in the treatment of varicocele(VC)and its influence on gonadotropin level.Methods A total of 86 VC patients treated in the First Affiliated Hospital of Zhengzhou University from March 2022 to February 2023 were selected for the cohort study.And they were divided into the microscope group and the laparoscopy group by random number table method,with 43 cases in each group.The microscope group was treated by microsurgical internal spermatic vein ligation,and the laparoscopy group was treated by laparoscopic internal spermatic vein ligation.The perioperative indicators,sperm quality,levels of gonadotropins,including follicle stimulating hormone(FSH),luteinizing hormone(LH)and testosterone(T),the International Index Erectile Function 5(IIEF-5)score,and the incidence of complications were compared between the two groups.Results Compared with the laparoscopy group,the microscope group had longer operation time,less intraoperative blood loss,and shorter hospital stay(P<0.05).The microscope group had higher active sperm count and sperm survival rate than the laparoscopy group 6 months after surgery(P<0.05).The microscope group had lower levels of FSH and LH,and had higher level of T than the laparoscopy group 6 months after surgery(P<0.05).The IIEF-5 score of the microscope group was higher than that of the laparoscopy group 6 months after surgery(P<0.05).The incidence of complications in the microscope group(4.65%,2/43)was lower than that in the laparoscopy group(20.93%,9/43),P<0.05.Conclusions Microsurgical internal spermatic vein ligation is effective in the treatment of VC,which can reduce intraoperative blood loss,shorten hospital stay,increase sperm survival rate and case fatality rate,and improve levels of gonadotropin,with fewer complications and better prognosis.
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